西藏自治区妇女子宫颈人乳头状瘤病毒感染现状调查及相关因素分析

Prevalence of human papillomavirus infection in women in Tibet Autonomous Region of China

目的了解我国西藏自治区妇女宫颈人乳头状瘤病毒（HPV）感染率和亚型分布及与HPV感染相关的因素。方法于2007年8月，采用整群抽样的方法对西藏自治区拉萨、日喀则和那曲3个地区的3036例妇女进行流行病学问卷凋杏和HPVDNA分型检测，并对与HPV感染相关的因素进行单因素及多网素分析。结果3036例妇女中，HPV感染患者为279例，总感染率为9．19％（279／3036），其中高危型HPV、低危型HPV和HPV复合感染率分别为7．05％（214／3036）、2．14％（65／3036）和1．32％（40／3036）；不同年龄、民族、地区妇女间HPV感染率比较，差异均无统计学意义（P〉0．05）。HPV感染的亚型中，HPV16（1．52％）最常见，其次为HPV33（1．42％）、58（1．22％）、52（1．15％）和31（1．05％）；不同年龄妇女中，HPV感染的亚型分布也略有不同。单因素分析显示，婚姻状态、初次性生活年龄和妊娠次数为影响HPV感染的危险因素（P〈0．05）。多因素分析表明，吸烟（P=0．027）、性伴侣数（P=0．198）和初次性生活年龄（P=0．237）为影响HPV感染的独立危险因素。结论两藏自治区妇女宫颈HPV感染率低于国内外平均水平，其最常见的亚型为HPV16。影响HPV感染的独立危险因素为吸烟、性伴侣数和初次性生活年龄。

Objective To determine the prevalence of cervical type-specific human papillomavirus （HPV） infection as well as risk factors associated in Tibet Autonomous Region of China. Methods A cluster sampling study was performed in Lasa, Rikaze and Naqu of Tibet. An epidemiological questionnaire was applied and 3036 cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included Wald Chi-square and stepwise logistic regression model. Results The overall HPV prevalence of involved 3036 women was 9. 19% （279/3036） , of which 7.05% （214/3036） of the women were infected by high-risk types （including 14 sorts of types） and 2. 14% （65/3036） by low-risk types （including 6 sorts of types ）. There were no significant differences of HPV prevalence between age groups （ P = 0. 936）, race （ P = 0. 718 ） and areas （ P = 0. 746 ）, respectively. Twenty-one types of HPV were detected, of which HPV16 （ 1.52% ） was the most common type, followed by HPV33 （ 1.42% ）, HPV58 （ 1.22% ）, HPV52 （ 1.15% ）, and HPV31 （ 1.05% ）. HPV type distribution was varied by age. Of the 279 HPV infected women, 14. 3% （40/279） exhibited multiple HPV infections. Independent risk factors for HPV infection were smoking （P =0. 027）, number of sex partners （P =0. 198） and early age of first intercourse （P = 0. 237 ）. Conclusion The overall prevalence of HPV infection in Tibet Autonomous Region is lower than that in China or abroad, in which the most common genotype is HPV16 and the independent risk factors for HPV infection included early age of first intercourse, smoking, and number of sex partners.